Abstract:
BACKGROUND:Tarsal tunnel pressure is increased when the foot and ankle are positioned in eversion or inversion from neutral, aggravating symptoms of tarsal tunnel syndrome in some patients. Space-occupying lesions may cause tarsal tunnel syndrome. We hypothesized that positional change of the foot and ankle from neutral to eversion or inversion causes decreased tarsal tunnel compartment volume that may aggravate symptoms of posterior tibial nerve entrapment. METHODS:MRI of 13 ankles in nine healthy subjects in three positions (neutral, eversion, inversion) were obtained with respect to the malleolar-calcaneal plane; this plane was defined by the distal tip of the anterior colliculus of the medial malleolus, the medial tubercle of the posterior calcaneal tuberosity, and the lateral tubercle of the posterior calcaneal tuberosity. The borders of the tarsal tunnel noted on the MRI were traced with a computer digitizing apparatus to determine the cross-sectional area of the tarsal tunnel on each image, and the slice thickness and interspace distance for the seven central images were used to calculate tarsal tunnel volume. RESULTS:The mean tarsal tunnel volume was significantly greater when the foot and ankle were in neutral position (21.5 +/- 0.9 cm(3)) than in either full eversion (18.0 +/- 0.9 cm(3); p = or < 0.001) or inversion (20.3 +/- 1.0 cm(3); p = or < 0.001). CONCLUSIONS:The results support the hypothesis that eversion and inversion of the foot and ankle cause decreased compartment volume of the tarsal tunnel and increased tarsal tunnel pressure that may contribute to symptoms of posterior tibial nerve entrapment in tarsal tunnel syndrome. CLINICAL RELEVANCE:Neutral immobilization of the foot and ankle may relieve symptoms of posterior tibial nerve entrapment in tarsal tunnel syndrome by minimizing pressure on the nerve and maximizing tarsal tunnel compartment volume available for the nerve.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Bracilovic A,Nihal A,Houston VL,Beattie AC,Rosenberg ZS,Trepman Edoi
10.1177/107110070602700608subject
Has Abstractpub_date
2006-06-01 00:00:00pages
431-7issue
6eissn
1071-1007issn
1944-7876pii
928161journal_volume
27pub_type
杂志文章abstract::Bilateral symmetrical Achilles tendon ossification is presented, with a fracture on one side. A 57 year old male patient was conservatively treated for bilateral clubfeet in his childhood. Part of his Achilles tendons were replaced by ectopic bony mass and on the left it fractured without any trauma. The fracture was ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002101206
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abstract:RECOMMENDATION:Transfer of synovial aspirate in blood culture bottles, obtaining deep biopsy of tissues and bone, obtaining multiple samples, increasing incubation period of cultures, and the use of molecular techniques for culture negative cases are some of the strategies that can help improve the ability to isolate t...
journal_title:Foot & ankle international
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abstract::The effect of a simulated leg length discrepancy on foot loading patterns and gait cycle times in normal individuals was investigated. Thirty feet of 15 normal volunteers were evaluated. Leg length discrepancy was simulated using flexible polyurethane soles. As leg length discrepancy increased, the total loading incre...
journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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